The Financial Cost of Substance Abuse

According to a national survey, 22.7 million Americans struggled with substance use disorders in 2013, but only 2.5 million received treatment. The gap between those who need treatment and those who receive it occurs largely for two reasons: many addicts do not seek treatment and those who do are often unable to afford it. In fact, over 45% of those who wanted treatment did not have the resources to get it. All totaled, the health, legal, criminal justice and social costs of substance abuse were approximately $200 billion in 2007 and perhaps as much as $600 billion in 2014.

In 2009, the U.S. spent $24 billion on substance use disorder treatment alone. About 31% of treatment spending came from private sources, including health insurance and personal spending. The other 69% came from state and local governments, Medicaid, Medicare, and federal grants, with the majority coming from states and communities, although the amounts vary widely by state. In 2013, for example, Wisconsin spent $3,750 on substance abuse treatment, while its neighbor Minnesota spent $114,974. Most treatment these days occurs in relatively inexpensive settings, such as 12-step groups and outpatient programs, but spending is much higher for those who need residential treatment. Outpatient treatment costs vary by program and patient needs, but the maximum is about $5,000 for 90 days. A standard residential program lasting 30 days costs between $6,000 and $20,000. It’s not hard to see how low-income addicts with little or no insurance could get stuck.

However much rehab costs, experts agree that treatment is far less expensive than addiction. For example, the average cost for a year of methadone maintenance treatment is approximately $4,700 per patient, but a year in prison costs approximately $24,000 per person. According to several conservative estimates, every dollar invested in addiction treatment programs returns between $4 and $7 in reduced drug-related criminal costs. The Affordable Care Act expanded support for addiction treatment, but as-yet-unspecified changes to this health care law may affect the availability and cost of treatment.